Background: Studies completed over the past decade suggest the presence of a gap between what students learn during medical school and their clinical responsibilities as first-year residents. The purpose of this survey was to verify on a large scale the responsibilities of residents during their initial months of training.
Method: Practice analysis surveys were mailed in September 2009 to 1,104 residency programs for distribution to an estimated 8,793 first-year residents. Surveys were returned by 3,003 residents from 672 programs; 2,523 surveys met inclusion criteria and were analyzed.
Results: New residents performed a wide range of activities, from routine but important communications (obtain informed consent) to complex procedures (thoracentesis), often without the attending physician present or otherwise involved.
Conclusions: Medical school curricula and the content of competence assessments prior to residency should consider more thorough coverage of the complex knowledge and skills required early in residency.
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